Provider Demographics
NPI:1508288655
Name:VIRGINIA BAPTIST CHILDRENS HOME AND FAMILY SERVICES
Entity Type:Organization
Organization Name:VIRGINIA BAPTIST CHILDRENS HOME AND FAMILY SERVICES
Other - Org Name:HOPE TREE FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-314-4928
Mailing Address - Street 1:860 MOUNT VERNON LN
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2700
Mailing Address - Country:US
Mailing Address - Phone:540-389-5468
Mailing Address - Fax:
Practice Address - Street 1:3309 W HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-2116
Practice Address - Country:US
Practice Address - Phone:804-201-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACPA-13253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0100298642Medicaid